title: Microendoscopic decompression for cervical spondylotic myelopathy.
abstract: OBJECTIVE
  Cervical spondylotic myelopathy (CSM) is a common cervical degenerative disease that affects the elderly population. Spinal cord decompression is achieved through various anterior and posterior approaches including anterior cervical decompression and fusion, laminectomy, laminoplasty, and combined approaches. The authors describe another option, minimally invasive endoscopically assisted decompression of stenosis (MEDS), which obviates the need for muscle dissection and disruption of the posterior tension band, a cause of postlaminectomy kyphosis.
  
  
  METHODS
  The authors conducted a retrospective study of 10 patients with CSM who underwent MEDS from January 2002 through July 2012. Data were collected on demographics, preoperative and postoperative Nurick scores, postoperative Odom scores, and preoperative and postoperative Cobb angles.
  
  
  RESULTS
  The mean patient age (± SD) was 67 ± 7.7 years; 8 patients were male. The average number of disc levels operated on was 2.2 (range 1-4). The mean Nurick score was 1.6 ± 0.7 preoperatively and improved to 0.3 ± 0.7 postoperatively (p < 0.0005). The postoperative Odom scores indicated excellent outcomes for 4 patients, good for 3, fair for 2, and poor for 1. The average preoperative focal Cobb angle at the disc levels operated on was -0.43º ± 1.9º. The average Cobb angle at the last follow-up visit was 0.25° ± 1.6° (p = 0.6). The average follow-up time was 18.9 ± 32.1 months. There were no intraoperative or postoperative complications.
  
  
  CONCLUSIONS
  For selected patients with CSM, whose pathologic changes are primarily posterior and who have acceptable preoperative lordosis, MEDS is an alternative to open laminectomy and laminoplasty.
authors.affiliation: Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
authors.forename: Nader S
authors.initials: NS
authors.lastname: Dahdaleh
authors.forename: Albert P
authors.initials: AP
authors.lastname: Wong
authors.forename: Zachary A
authors.initials: ZA
authors.lastname: Smith
authors.forename: Ricky H
authors.initials: RH
authors.lastname: Wong
authors.forename: Sandi K
authors.initials: SK
authors.lastname: Lam
authors.forename: Richard G
authors.initials: RG
authors.lastname: Fessler
mesh_terms: D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D044583:Neuroendoscopy / Q000379:methods*; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000601:surgery*; D055009:Spondylosis / Q000175:diagnosis / Q000601:surgery*